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The causes of children's institutionalization in Romania. The Children's Health Care Collaborative Study Group
Insights
Romanian children aged 0-3 years in institutions often have chronic health issues and complex family social problems. Most are referred by pediatricians and hospitals, with many likely to remain in institutional care.
Area of Science:
- Child Health
- Social Determinants of Health
- Public Health Policy
Background:
- High rates of institutionalization for young children in Romania present significant public health challenges.
- Understanding the root causes of this institutionalization is crucial for effective intervention and policy development.
Purpose of the Study:
- To investigate the primary causes and contributing factors leading to the institutionalization of children aged 0-3 years in Romania.
- To identify the health status and family social circumstances of institutionalized children.
Main Methods:
- A nationwide, cross-sectional survey involving 628 randomly sampled children aged 0-3 years.
- Data collection included interviews with institutional directors, review of child records, and brief medical/developmental evaluations.
Main Results:
- Institutionalized children frequently present with one or more chronic health conditions.
- Families of these children face multiple, complex social challenges.
- Pediatricians were involved in the referral of 76% of children, with 54% referred from pediatric and maternity hospitals.
Conclusions:
- The institutionalization of young Romanian children is strongly linked to their chronic health conditions and their families' social adversities.
- Current referral pathways predominantly involve healthcare professionals and facilities.
- A significant majority of institutionalized children are expected to remain in care, highlighting the need for systemic changes.
Abstract:
A country-wide, cross-sectional survey was conducted to determine the causes of institutionalization of Romanian children aged 0-3 years. A total of 628 children were sampled at random. Interview were conducted with directors of institutions and records of each sampled child were reviewed. Each sampled child was given a brief medical and developmental evaluation. The children in Romanian institutions have one or more chronic health conditions. Their families have multiple, complex social problems. The referral to institutions usually involved a paediatrician (76% of children). Fifty-four per cent of children were referred primarily from paediatric and maternity hospitals. The majority of children currently interned are likely to remain in institutional care. Implications for policy and re-organization of health and social services are discussed.